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Peripheral Neuropathy

What is peripheral neuropathy?

Peripheral neuropathy is a type of damage to the nervous system. Specifically, it is a problem with your peripheral nervous system. This is the network of nerves that sends information from your brain and spinal cord (central nervous system) to the rest of your body.

There are more than 100 types of peripheral neuropathy, each with its own set of symptoms and prognosis. To help doctors classify them, they are often broken down into the following categories:

Motor neuropathy. This is damage to the nerves that control muscles and movement in the body, such as moving your hands and arms or talking.

Sensory neuropathy. Sensory nerves control what you feel, such as pain, temperature or a light touch. Sensory neuropathy affects these groups of nerves.

Autonomic nerve neuropathy. Autonomic nerves control functions that you are not conscious of, such as breathing and heartbeat. Damage to these nerves can be serious.

Combination neuropathies. You may have a mix of 2 or 3 of these other types of neuropathies, such as a sensory-motor neuropathy.

What causes peripheral neuropathy?

Peripheral neuropathy has many different causes. Some people inherit the disorder from their parents. Others develop it because of an injury or another disorder.

In many cases, a different type of problem, such as a kidney condition or a hormone imbalance, leads to peripheral neuropathy. One of the most common causes of peripheral neuropathy in the U.S. is diabetes.

What are the risks for peripheral neuropathy?

These are risk factors for peripheral neuropathy:

Diabetes

Kidney disease

Hormone imbalance

Family history of peripheral neuropathy

What are the symptoms of peripheral neuropathy?

The symptoms of peripheral neuropathy vary based on the type that you have and what part of the body is affected. Symptoms can range from tingling or numbness in a certain body part to more serious effects such as burning pain or paralysis.

Muscle weakness

Cramps

Muscle twitching

Loss of muscle and bone

Changes in skin, hair, or nails

Numbness

Loss of sensation or feeling in body parts

Loss of balance or other functions as a side effect of the loss of feeling in the legs, arms, or other body parts

Emotional disturbances

Sleep disruptions

Loss of pain or sensation that can put you at risk, such as not feeling an impending heart attack or limb pain

Inability to sweat properly, leading to heat intolerance

Loss of bladder control, leading to infection or incontinence

Dizziness, lightheadedness, or fainting because of a loss of control over blood pressure

Diarrhea, constipation, or incontinence related to nerve damage in the intestines or digestive tract

Trouble eating or swallowing

Life-threatening symptoms, such as difficulty breathing or irregular heartbeat

The symptoms of peripheral neuropathy may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.

How is peripheral neuropathy diagnosed?

The symptoms and body parts affected by peripheral neuropathy are so varied that it may be hard to make a diagnosis. If your healthcare provider suspects nerve damage, he or she will take an extensive medical history and do a number of neurological tests to determine the location and extent of your nerve damage. These may include:

Blood tests

Spinal fluid tests

Muscle strength tests

Tests of the ability to detect vibrations

Depending on what basic tests reveal, your healthcare provider may want to do more in-depth scanning and other tests to get a better look at your nerve damage. Tests may include:

CT scan

MRI scan

Electromyography (EMG) and nerve conduction studies

Nerve and skin biopsy

How is peripheral neuropathy treated?

Usually a peripheral neuropathy can’t be cured, but you can do a lot of things to prevent it from getting worse. If an underlying condition like diabetes is at fault, your healthcare provider will treat that first and then treat the pain and other symptoms of neuropathy.

In some cases, over-the-counter pain relievers can help. Other times, prescription medicines are needed. Some of these medicines include mexiletine, a medicine developed to correct irregular heart rhythms; antiseizure drugs, such as gabapentin, phenytoin, and carbamazepine; and some classes of antidepressants, including tricyclics such as amitriptyline.

Lidocaine injections and patches may help with pain in other instances. And in extreme cases, surgery can be used to destroy nerves or repair injuries that are causing neuropathic pain and symptoms.

Can peripheral neuropathy be prevented?

Lifestyle choices can play a role in preventing peripheral neuropathy. You can lessen your risk for many of these conditions by avoiding alcohol, correcting vitamin deficiencies, eating a healthy diet, losing weight, avoiding toxins, and exercising regularly. If you have kidney disease, diabetes, or other chronic health condition, it is important to work with your healthcare provider to control your condition, which may prevent or delay the onset of peripheral neuropathy.

Living with peripheral neuropathy

Even if you already have some form of peripheral neuropathy, healthy lifestyle steps can help you feel your best and reduce the pain and symptoms related to the disorder. You’ll also want to quit smoking, not let injuries go untreated, and be meticulous about caring for your feet and treating wounds to avoid complications, such as the loss of a limb.

In some cases, non-prescription hand and foot braces can help you make up for muscle weakness. Orthotics can help you walk better. Relaxation techniques, such as yoga, may help ease emotional as well as physical symptoms.

Key points about peripheral neuropathy

Neuropathy affects the body in many different ways, including how well you’re able to use your muscles, feeling and sensation in your various body parts, and other body functions that are automatic such as your heartbeat.

Medicines can improve your symptoms.

If is important that you control any other diseases you may have to reduce your risk for peripheral neuropathy.

If you think you may have peripheral neuropathy, it is important to talk with your healthcare provider.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

Know the reason for your visit and what you want to happen.

Before your visit, write down questions you want answered.

Bring someone with you to help you ask questions and remember what your provider tells you.

At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

Ask if your condition can be treated in other ways.

Know why a test or procedure is recommended and what the results could mean.

Know what to expect if you do not take the medicine or have the test or procedure.

If you have a follow-up appointment, write down the date, time, and purpose for that visit.

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